• The Korean Journal of Pain
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• 제10권1호
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• pp.131-133
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• 1997

Number of elderly patients requiring nerve blocks have been increasing in recent years. We had two elderly patients who suffered stroke one day and three days after lumbar facet joint block and lumbar single epidural block respectively. Both patients due to their advanced age had potential risk factor to suffer one or more of the following; stroke, hypertension, and diabetes mellitus. Due to our experience with these patients, we suggested the following: (1) Nerve blocks should be reconsidered for elderly patient who posesses a potential risk factor to suffer a stroke. (2) Prior to invasive block administration of mild sedatives or analgesics may provide beneficial effects for patients with hypertension. (3) Adequately informed consent must be fully discussed time of consultation with patient scheduled for nerve block especially for elderly and risky patient.

• Journal of Chest Surgery
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• 제50권3호
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• pp.211-214
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• 2017

Outcomes of ventricular septal rupture (VSR) as a complication of acute myocardial infarction are extremely poor, with an in-hospital mortality rate of 45% in surgically treated patients and 90% in patients managed with medication. Delaying surgery for VSR is a strategy for reducing mortality. However, hemodynamic instability is the main problem with this strategy. In the present case, venoarterial extracorporeal membrane oxygenation (ECMO) was used to provide stable hemodynamic support before the delayed surgery. Awake ECMO was also used to avoiding the complications of sedatives and mechanical ventilation. Here, we describe a successful operation using awake ECMO as a bridge to surgery.

• 대한한의학회지
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• 제22권4호
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• pp.101-106
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• 2001

Objectives : Zizyphus seed has long been used in hypnotics and sedatives in oriental medicine, and it is reported that the Zizyphus seed elicited a variety of pharmacological actions besides CNS depression. We did a clinical study on the effectiveness of Zizyphus seed (Ansim-san) for insomnia in stroke patients. Methods : To 41 stroke patients suffering from insomnia, we administered the extract of Zizyphus seed (Ansim-san). Outcome measures were subjective in nature and included a morning questionnaire, visual analog scales, and observation forms by study personnel. We also, to find the applicable symptom-complex of Zizyphus seed (Ansim-san), examined accompanying symptoms. Results : 1. Zizyphus seed extract use meant that sleep latency was shorter, total sleep time was longer, number of wakenings was lower, wake time during sleep was shorter, sleep quality was improved, condition upon awakening was improved, ability to concentrate was improved, and the patients fell asleep more easily (P<0.001). There were no differences in morning sleepiness. 2. Among accompanying symptoms, an oppressed feeling in the chest was significant (P=0.035) in the patients who improved sleep quality. Conclusions : The results of this clinical study suggest that in stroke patients, Zizyphus seed (Ansim-san) can be effective for insomnia, and significantly effective in patients who have an oppressed feeling in the chest.

• 대한후두음성언어의학회지
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• 제20권1호
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• pp.11-16
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• 2009

OPD based laryngeal procedures offers a new avenue to the modern laryngologist, incorporating new technology in the office setting. With the development of flexible fiberoptic endoscopes, compact video system, and short acting anesthetics and sedatives allow these procedures. The success or failure of procedures are depend on excellent topical anesthesia. An inadequately anesthetized patient is apt to be uncomfortable, anxious and hyperresponsive and therefore unlikely to tolerate the procedure. On the other hand, a patient who is well informed, reassured, and thoroughly anesthetized can complete procedures. Therefore, optimal anesthesia is obligatory for excellent surgical results. The phonosurgeon should choose the anesthetic and sedative agents based on duration of action, time of onset of action, and any medical contraindications that the patient may have. And should be familiar with the properties and interaction of the agents used, as well as the signs of toxicity.

• 생명과학회지
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• 제10권4호
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• pp.374-379
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• 2000

This study was attempted to evaluate an agonistic activity to benzodiazepine receptor of several medicinal pants, which have been used as sedatives in oriental medicine. The activities of the methanol extracts of composite preparation of oriental drugs were compared with those of the simple drugs, furthermore, the active fraction was found out from the simple preparation. Inhibitory effects of composite preparations, Cyperus rotundus/Acorus gramineus, Thuja orientalis/Euphoria longan, Thuja orientalis/Albizzia julibrissin, on the binding of ${[^3H]}$Ro15-1788, a selective benszodiazepine receptor antagonist to benzodiazepine receptor of rat cortices, were observed to be lower than those of corresponding simple preparations. These unexpected results suggest that some components of the composite druge may rather act as an obstacle, not to show the sinergistic effect. The methanol extracts of Cyperus rotundus having the highest activity were fractionated using polar and nonpolar solvents to give ethylacetate and hexane fractions, respectively. The ethylacetate fraction containing relatively polar components exhibited much higher activity than the hexane fraction, which consiste of nonpolar agonist, binding to benzodiazepine receptor. However, in the presence of GABA, this fraction inhibited ${[^3H]}$flunitrazepan binding, and these positive GABA shift supported the strong possibility of agonistic activity to benzodiazepine receptro. As a result, it may be concluded that the substance or substances with neurochemical properties as a benzodiazepine receptor agonist may contribute to the sedative property of Cyperus rotundus.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권1호
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• pp.25-29
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• 2016

Background: The most important reason for pre-operative administration of medication is to reduce anxiety. Alleviation of fear and anxiety about surgery enables patients to remain comfortable during treatment. Dexmedetomidine (DEX) is a fast-acting drug that is used as a premedication in different circumstances because it has sedative and anti-anxiolytic effects, and stable hemodynamics. It also has the advantage of intranasal administration. The aim of this study was to investigate the effects and hemodynamic stability of DEX by retrospectively analyzing cases in which DEX was administered nasally as a premedication. Methods: Ten patients treated at Dankook University Dental Hospital, recruited between February and April 2015, received intranasal delivery of $2{\mu}g/kg$ DEX, 30 minutes prior to general anesthesia. Anesthesia records of anxiety, blood pressure, respiration, pulse, estimated arterial oxygen saturation ($SpO_2$), and partial pressure, or maximum concentration, of carbon dioxide ($ETCO_2$) were analyzed. Results: Administration of DEX prior to a general anesthetic effectively relieved anxiety. Respiratory depression, the most severe adverse effect of other sedatives, was not observed. Hemodynamic stability under general anesthesia was maintained during treatment and a reduction in emergence delirium was observed upon completion of treatment. Conclusions: Premedication administration of DEX is safe for pediatric patients undergoing dental treatment under general anesthesia.

• 사상체질의학회지
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• 제16권2호
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• pp.128-133
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• 2004

Objectives Generally speaking, we could've not been used moxibustion to Soyangin. But we thought what matters is that which point is chosen, not that what method is chosen. So we had a case of moxibustion at Ki1 for a Soyangin patient with insomnia Methods We managed a patient with insomnia after intracranial hemorrhage. He had been undergone conservative therapy, herb medicine, acupuncture, sedatives. 20 days after admission we started to do moxibustion at both Ki 1 point(湧泉). We used artemisia and, the method was direct form. Results The duration and the quality of sleep of the patient was improved. After 10 days, he could sleep for 5 hours. Accompanied symptoms, as mentality, urination, and defication, was also improved. Conclusions From this case we could accept the efficacy of moxibustion at Ki 1 for Soyangin patient suffering from insomnia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권3호
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• pp.107-118
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• 2020

Chloral hydrate is the oldest and most common sedative drug used in moderate sedation for pediatric dental patients. Hence, the purpose of this article is to review the safety and possible adverse events of this drug when used for pediatric dental treatment. A bibliographic search in PubMed, MEDLINE, Cochrane Library and KMbase, KISS, DBpia, KoreaMed, and RISS databases was performed. Using the keywords "dental sedation," "chloral hydrate," and "children or adolescent," 512 scientific articles were found. Subsequently, 183 studies were individually assessed for their suitability for inclusion in this literature review. Altogether, 24 studies were selected. They included 12 cases of death before, during, or after chloral hydrate sedation for dental treatment, majorly due to dosing error and use of multiple sedatives. Additionally, intraoperative adverse events were mostly respiratory problems such as hypoxia and apnea, but most events were temporary. After treatment, prolonged sedation, including excessive sleep and less activity were the most common postoperative adverse events, and even death cases were reported. Despite the wide acceptance of chloral hydrate as a sedative-hypnotic agent, the risk of adverse events and adequate dose should be of great concern when using it for pediatric dental sedation.

• Journal of Chest Surgery
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• 제54권5호
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• pp.396-399
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• 2021

A 58-year-old man, incapable of maintaining oxygen saturation with mechanical ventilation, was admitted to our hospital for veno-venous extracorporeal membrane oxygenation (ECMO) treatment. He was diagnosed with acute respiratory distress syndrome (ARDS) due to influenza A pneumonia. His condition stabilized with antibiotics and steroid administration, but weaning from ECMO failed due to post-infectious pulmonary sequelae. On day 84 after admission, he underwent bilateral lung transplantation. In the postoperative phase, he did not regain consciousness even after discontinuation of sedatives for 3 days. However, spontaneous pupillary reflex and eye movements were preserved, while communication and upper and lower limb movements were affected. The nerve conduction study was diagnostic of Guillain-Barré syndrome. He was managed with intravenous immunoglobulins and plasmapheresis. Mild recovery of the facial muscles was seen, but he died 24 days post-surgery due to progressive ARDS and sepsis.

• Journal of Hospice and Palliative Care
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• 제24권4호
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• pp.254-260
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• 2021

Continuous deep sedation (CDS) is an extreme form of palliative sedation to relieve refractory symptoms at the end of life. In this study, we shared our experiences with CDS and examined the clinical characteristics associated with survival in patients with terminal cancer who received CDS. We conducted a chart audit of 106 consecutive patients with terminal cancer who received CDS at a single hospice care unit between January 2014 and December 2016. Survival was defined as the first day of admission to the date of death. The associations between clinical characteristics and survival were presented as hazard ratios and 95% confidence intervals using a Cox proportional hazard model. The mean age of participants was 65.2 years, and 33.0% (n=35) were women. Diazepam was the most commonly administered drug, and haloperidol or lorazepam were also used if needed. One sedative was enough for a majority of the patients. Stepwise multivariate analysis identified poor functioning, a high Palliative Prognostic Index score, hyperbilirubinemia, high serum ferritin levels, and a low number of sedatives as independent poor prognostic factors. Our experiences and findings are expected to be helpful for shared decision-making and further research on palliative sedation.